Transcript:

MATT CLANCY

This is Matt Clancy, director of recruitment solutions for NEJM Group. I’m talking today with Allan Cacanindin, system vice president physician and provider recruitment at SSM Health and current president of the board of directors at the association for advancing physician and provider recruitment. Over more than two decades in health care, Allan has advised and worked with health care organizations nationally on the evolving physician workforce, recruitment market, and candidate experience. His work focuses on helping health care organizations anticipate workforce needs while helping physicians make informed, meaningful career decisions. Allan, thank you for speaking with me today.

ALLAN CACANINDIN

Matt, thank you. It’s a pleasure to be here. I’ve spent much of my career thinking about this issue from both sides of the table. what health care organizations need to build a strong physician workforce, but equally important, what physicians need to build meaningful careers. I’m looking forward to the conversation.

CLANCY

Excellent. I expected nothing less. Allan, you lead physician and provider recruitment across SSM Health. And you also serve as president of AAPR. How does that dual perspective shape the way you see the physician job market today?

CACANINDIN

Matt, it gives me the opportunity to see the market through two very different but complementary lenses. At SSM Health, I see it at the ground level every day. What physicians are looking for and what communities have needs where access is challenged and ultimately what causes a physician to say yes to one organization and no to another. And through AAPR, I have the privilege of seeing a much broader national picture. And what intrigues me Is, this is no longer simply a recruitment issue. It’s a workforce issue. It’s an access issue and increasingly a strategic issue for health care.

We’ve known the physician shortage is real. But the story is more nuanced than simply having too few physicians. We have geographic disparities. We have specialty shortages, changing expectations around work and life. And a new generation of physicians asking very thoughtful questions about how and where they want to practice. And that creates an opportunity. The organizations that will succeed are going to be the ones that listen carefully, plan earlier, and remain agile. They create environments where physicians can do the work they were trained to do while still having a meaningful life outside of medicine.

And that’s a conversation we’re having here at SSM Health. We’re working to move the discussion further upstream from simply filling and opening to anticipating where our communities will need physicians years from now. Building those relationships a lot earlier and then being flexible enough to respond to what individual physicians value. And physicians should test that agility. For instance, is the organization willing to understand what matters to you and where possible, customize the opportunity whether that’s the practice model, schedule, professional development or incentives because one size no longer fits all. And the best organizations understand that and the best candidates should be looking for it.

CLANCY

Yes. So much has changed in health care and in physician recruitment that both systems need to be thoughtful and forward thinking about how they’re going to handle those conversations. But like you’re saying informed candidates are going to be the most successful when either beginning their career searches or looking for the next step within their career.

Allan, you have a unique lens into this landscape. From what you’re seeing both nationally and inside a health system, what’s changed most about the physician job search over the last few years?

CACANINDIN

How long do we have, Matt? I would say the biggest change, is that physicians are evaluating the whole experience, not simply just the job itself. Compensation still matters, of course it does, but increasingly physicians are asking much deeper questions. For instance, what will my life look like here? Who will I work with? Will I have the resources and support to practice medicine well? What’s the culture like? Does the mission align with my own? And can my family and I see ourselves building a life in this community?

That’s a significant shift. And because demand remains strong in many specialties, physicians can afford to be discerning. They’re using AI to help compare opportunities. They’re starting their searches earlier and they have access to more information than ever before.

Organizations have had to change as well. Recruitment can’t simply be transactional. Post a position, conduct an interview, make an offer. In truth, the best recruitment today is relational. And that’s something we think a great deal about here at SSM Health. The candidate experience should begin long before an interview and continue well beyond an accepted offer. It’s about understanding the person behind the CV, their aspirations, their family, what they want to practice and their life, what they want their life to become. And then determining whether there’s an authentic match. Because ultimately, we’re not simply recruiting someone for their next job. We’re helping them choose the next chapter of their career journey. And if we do that well, recruitment becomes less about convincing someone to join you and more about discovering together whether you’re the right one for one another. If that makes sense.

CLANCY

It does. It’s a partnership on an individual level, right? And both parties involved in the conversation are making decisions that hopefully are going to be successful over a long term. And weighing multiple categories and making sure you’re aligned on those categories is going to make for a successful partnership moving forward, if you will. And I think that dovetails well into my next question for you, which is, if a physician came to you today and said, “I’m thinking about my next career move. Where should I start?” Allan, what would you tell them?

CACANINDIN

I’d tell them, before you begin looking around and looking outward, spend some time looking inward. Before you set up your AI agent or start taking calls, decide what matters most to you. What kind of medicine do you want to practice? What kind of colleagues do you want around you? Do you want academic? Do you want community? Do you want a large system? Maybe a smaller environment. How important is a couple of the other different factors like geography, family proximity, leadership opportunities, research, schedule, call, or even simply autonomy? And then distinguish between your must-haves and your nice-to-haves.

Now that sounds simple, but it’s incredibly important because the most attractive opportunities online don’t necessarily mimic the right opportunity for you or may not be the right opportunity for you. And I’d also encourage physicians to start earlier than they think they need to. Use AI. Absolutely. I think everyone is using it already. But don’t lose the human element of relationships. Have conversations. Grow your network, build rapport, and ask questions. And don’t limit your search to what’s posted on a website today. Some of the best opportunities begin with a simple conversation about what could be possible versus simply what’s currently available.

That’s I would say is an important distinction, particularly with organizations that are thinking strategically about their future workforce. Sometimes the right conversations can uncover an opportunity that hasn’t even been created yet. And So a career search should be a process of discovery, not simply just a transaction at the end of training or when you’re ready to leave a position. And I would begin with this understanding. Clarity gives you leverage. And I’ll say that again. Clarity gives you leverage. When you understand what you value, you become much better at recognizing the right opportunity when it appears.

CLANCY

I think that’s great. It harkens back to what we just talked about, which is this is hopefully a successful partnership. And in order to achieve that, communication is key. Thought is key. And it can be easy for physicians who are exceptionally busy people to think of it as a systemic A to B to C type of process. And that may work for people, but if you’re willing to take the time to have conversations both with yourself and with others about what’s going to work best, it leads you down a successful path.

CACANINDIN

Indeed.

CLANCY

Allan, you’ve worked with physicians and health care organizations for many years. You’ve seen a lot of candidates. What makes a physician candidate stand out? And when I say that, I mean for the right reasons.

CACANINDIN

Matt, interestingly, it’s not usually the longest CV. Certainly credentials and clinical excellence matter, don’t get me wrong, but once you’re sitting across the table from a hiring leader, what often differentiates someone are three things. One, curiosity. Two, authenticity. And three, engagement. The strongest candidates interview the organization just as thoughtfully as the organization is interviewing them. They’ve done their homework. They ask about patients and the community. They want to understand the team, the culture, the organization’s overall strategy, and what success looks like for three, four, five years from now. And importantly, they can articulate what they hope to contribute. Matt, there’s a big difference between simply asking, what can this organization give me versus asking, what can we build together? And that signals something very different.

You see, health care is ultimately a team endeavor. Organizations are certainly looking for outstanding clinicians, but they’re also looking for colleagues, partners, and importantly, future leaders.

I’ll say this. Clinical credentials may open the door, but honestly, character, curiosity, and connection are often what distinguish the candidate themselves.

CLANCY

I think that’s great. It speaks to the complexities behind what the job requires. And certainly skills that either are already innately had or can be built and things for consideration moving forward.

Sticking on the candidate side of things, when physicians are comparing opportunities, what should they be evaluating beyond compensation?

CACANINDIN

I would encourage physicians to look at compensation as just one part of a much larger equation. For instance, they need to ask themselves, what am I joining? Look at the leadership, look at the culture of the practice, speak with physicians who are already practicing there and not just the people on the formal interview itinerary. I would ask also about turnover. Ask about how decisions are made. Ask what happens when physicians raise concerns. Understand call structure, staffing, [app] support, maybe technology, and how it’s used. What are the administrative day-to-days? And whether you will have the resources to practice medicine the way you want to practice it.

Again, test the organization’s flexibility. If something is important to you, ask about it. Don’t assume the initial offer represents the only way the opportunity can be structured. The answer may sometimes be no, and that’s okay. Agility doesn’t mean saying yes to everything. It means being willing to listen, understanding the need, and thoughtfully exploring what might be possible. And that distinction is incredibly important. And frankly, that’s the kind of culture we’re continuing to build here at SSM Health. We may not always be able to say yes, but we want physicians to experience an organization willing to listen, have the conversation, and look for solutions.

How an organization responds to that conversation can tell you quite a bit about the organization itself. And then look beyond the practice and think about the community and the culture. Perhaps your spouse or your partner, your children, your support system, how will they fit in? And maybe even ask, what will an ordinary Tuesday look like? Not simply interview day.

I’ve seen physicians accept the highest offer and discover a year later that it wasn’t the best opportunity. And I’ve seen physicians choose an organization because they found the right colleagues, the right community, and a genuine sense of purpose. And they remain there for decades. Understand your market value and negotiate fairly, but don’t confuse price with value. And the better question isn’t simply what will it pay me? It’s, can I build a career and the life I want here? And that question tends to lead to much better decisions.

CLANCY

That’s, excellent advice, Allan. There are a lot of days in between your first day and your last day. And it’s the experience that you have in those in-between days and the little intricacies that go into the job that build fulfillment, build satisfaction. And understanding those — it goes back to the concept of communication — understanding those during your discovery process is a helpful component of the process.

Allan, you are a repository of information and I could probably keep you going for far too long. But let me let me get you out of here on this one. For a physician thinking about making a career move right now, what’s the one thing you want them to remember?

CACANINDIN

I would want them to remember to choose their next chapter, not simply their next job. Look, medicine is an extraordinary calling, but it’s also a long career. And the decisions you make about where you practice and who you practice alongside and what kind of organization you will join will shape you far more than your compensation. Truthfully, they will shape your family, your sense of purpose, your ability to care for patients and ultimately how you feel about the profession years from now. And this is where in our world where mission matters.

One of the things I value about our organization at SSM Health is that our mission calls us to something larger than ourselves. And whether someone chooses SSM Health or another organization, I would encourage every physician to find a place where the mission on the wall is actually viable in the way people lead, make decisions, treat one another, and care for their communities. So, be thoughtful. Ask some difficult questions. Know what matters to you and don’t be afraid to wait for the opportunity where the values, the people, and the purpose align. Because when you find that alignment, you don’t simply find a place to work. You find a place where you can make a difference while continuing to thrive and flourish in your career. And in the end, I believe that’s what most of us came into health care hoping to do.

CLANCY

Allan, that’s a good way to end this conversation. Thank you so much for sharing your insights. I truly hope we can do this again soon.

CACANINDIN

Absolutely, Matt. I’ve enjoyed it and thank you to you and NEJM Career Center for creating the opportunity to have this conversation. If it helps even one physician be a little more thoughtful and confident about their next career decision, then I think we’ve accomplished something worthwhile.